What Is Regenerative Orthopedics?
Injections rather than an operation, placed under image guidance, to repair damaged tendons, ligaments and joints. The fuller answer is a sequence: what is examined, what is injected, in what order.
The definition, and the ceiling on it
NW Regen defines the field as non-surgical injection procedures that repair damaged tendons, ligaments and joints, regenerating tissue by working with the body's own healing capacity. On the regenerative orthopedics service NW Regen runs in Portland, it is framed as an alternative to orthopedic surgery and joint replacement — often delaying those operations for years, sometimes stopping them altogether.
The same page sets the ceiling: science moves daily, NW Regen writes, but the field has a long way to go before a body can be returned to its prime, and no treatment produces the same outcome in every patient. Plans are tailored, with an honest read on who benefits and who may not.
The four injections on the list
NW Regen's page on orthopedic injuries and trauma lists four non-surgical procedures:
- Regenerative joint injection therapy
- Solutions injected to stimulate healing and strengthen painful, injured joints — without surgery.
- Platelet-rich plasma
- Platelets from the patient's own blood, used to regulate inflammation, promote healing and restore damaged tissue.
- Tissue-graft injection therapy
- A graft of the patient's own tissue, rich in regenerative cells, for degenerative problems in ligaments, tendons and muscles.
- Perineural injection therapy
- Small injections of a pH-balanced solution that block receptors on the nerve endings behind pain and inflammation.
NW Regen also describes pairing these with bioidentical hormone therapy, IV nutritional infusions and lifestyle plans.
Guidance is part of the procedure
Two forms of precise guidance are named: fluoroscopy and musculoskeletal ultrasound sonography. Some ultrasound assistance belongs in nearly every regenerative injection, NW Regen's position runs: it helps diagnose the problem and locates the exact spot the injection should reach. A physician working without guidance should, by that standard, have decades of hands-on experience with traditional injection procedures.
How a first appointment runs
- Beforehand: new patient forms completed, records gathered, imaging reports or DVDs brought along.
- Roughly an hour and a half: intake forms and imaging reviewed, a history taken, the condition discussed.
- A focused physical exam, then a thorough musculoskeletal diagnostic ultrasound exam.
- Recommendations made, treatment scheduled; labs or further imaging needed are ordered and reviewed first.
What gets treated
Every joint in the body, per the conditions page above, plus ligament and tendon damage: knees, shoulders, hips, elbows, low back. The named list includes bursitis, tendonitis and arthritis, frozen shoulder, rotator cuff tears, herniated discs, meniscal and ACL tears, ankle instability, plantar fasciitis, Achilles tendinopathy, sciatica, sacroiliac joint dysfunction and chronic joint instability. NW Regen's acute and chronic pain page frames the goal as relief without steroids or surgery, and ranks arthritis first among U.S. causes of disability, in more than a hundred forms.
Raise these before treatment is agreed
NW Regen asks that five things be discussed with the treating clinician or a primary care physician first: chronic illness, acute infection, blood-based diseases, certain blood thinners that affect clotting, and cancer that has not been in remission for five years or more. In NW Regen's comparison of MFAT, PRP and prolotherapy, all three are called minimally invasive and generally safe — though, like any medical procedure, they carry potential risks. Most side effects are mild and temporary: for PRP and prolotherapy, mild discomfort and swelling, with a temporary increase in pain in some patients. MFAT can bring pain or swelling at the injection site and, because it involves a liposuction step, a somewhat higher chance of infection or bruising. Against surgery: minimal downtime and a lower risk of complications.
Paying for it, and vetting who does it
This is not typically a covered specialty. NW Regen is cash-pay, not a preferred provider with any insurer, and takes no Med-Pay or accident insurance; super bills listing procedures and diagnostic coding are supplied for claims, with no promise of reimbursement. The advice on choosing a physician is concrete: someone who performs these procedures as their sole profession, licensed and trained for them; who counts cells, so the therapeutic threshold going in is known and repeatable; who understands the FDA pathways behind anything injected from a vial; who tracks outcomes in software; who uses image guidance. NW Regen's primer on interventional orthopedic and orthobiologic medicine unpacks the specialty's name.
Sources
Everything on this page is drawn from pages published by NW Regen: